Cyclosporiasis cases are easing, but one state's count is 95% of the national total

One state cannot hold 95 percent of a national case count for a product that shipped to grocery stores and Taco Bell restaurants across the country ^[6][9]. Michigan's tally and the CDC's confirmed total, as reported by Scientific American, are not two measurements of the same thing, and the piece says so directly: some states are tracking this outbreak on a different basis than the federal count ^[5]. So the plateau is being declared against a denominator that does not hold still.

The tapering itself shows up in both datasets ^[4][17], but it describes eating that already happened. Symptoms can take up to six weeks to appear ^[11], so a file closed on August 18 mostly covers people exposed on or before about July 7 ^[12]. The mid-July peak in reports is a June and early-July contamination problem ^[4]. Anyone exposed in the final weeks before the recall cleared shelves is still in transit through the surveillance system.

The year-over-year scale is not in doubt even so. The CDC counted more than 14,000 additional cases compared with May 1 through August 31 of last year ^[2], which puts the prior baseline near 1,000 and this season at roughly fifteen times it ^[8]. That comparison also gives the current season 13 fewer days than the baseline window ^[18], so the gap is understated rather than inflated.

Severity math runs the other way. Confirmed cases translate to a 5.5 percent hospital admission rate ^[10], and that should be read as a ceiling: the CDC expects many thousands of unconfirmed infections, and the mildest ones are the least likely to be tested ^[16]. Correcting the denominator upward lowers the severity fraction and raises the total burden in the same move. Neither correction has been made.

The prevention guidance is where the produce-specific trap sits. Washing hands and rinsing produce under running water comes first, but the CDC concedes Cyclospora is harder to remove than that and offers cooking to at least 185 degrees Fahrenheit as the step that actually kills it ^[13]. For iceberg lettuce, cooking to 185 degrees is indistinguishable from throwing it out. That is why every meaningful control in this outbreak sat upstream of the kitchen: the FDA and CDC say they are confident all iceberg lettuce tied to this outbreak is off the market ^[7], and Michigan dropped its bagged-salad advisory on August 6, telling residents to resume normal handling according to their own risk tolerance ^[14].

Symptoms can persist from a few days to a month or more without treatment ^[15], which means the tail of this outbreak will be felt by people long after the reporting curve flattens. Until the federal and state case definitions are reconciled, the most that can be said is that the outbreak appears to be shrinking on a scale nobody has standardised.